In light of the important prehospital airway management articles that came out this week, I thought it might be helpful to go into more depth on the topic of prehospital airway management.

EMS providers had 39% greater odds of death by suicide than the general population in this Arizona-based sample. This problem is real. Reach out if you need help. See below.

It is estimated that to place an endotracheal tube (ETT) successfully in 30-60 seconds, using direct laryngoscopy, would take 3-5 years of experience and 137-243 endotracheal intubations (ETI). Increased experience did not reduce the time chest compressions were paused. The key take home is that ETI during CPR is really hard. Be prepared.

There was no difference in good neurological recovery after non-traumatic out-of-hospital cardiac arrest at 30 days with use of a supraglottic airway compared to endotracheal tube.

For adults with out-of-hospital cardiac arrest, initial laryngeal tube insertion by emergency medical service providers was associated with improved 72-hour survival, return of spontaneous circulation, hospital survival, favorable neurologic outcome, and airway success compared to initial endotracheal tube insertion.

Four mass casualty incident (MCI) triage sorting systems performed similarly in children, each 57-59% accurate. Those considered were SALT, JumpSTART, Triage Sieve, and CareFlight.

Ketamine was effective for treatment of agitation, but 30% of patients given higher doses IM by EMS were intubated once in the ED.

The American College of Surgeons Committee on Trauma, American College of Emergency Physicians, and the National Association of EMS Physicians have offered a joint consensus statement on spinal motion restriction in trauma patients.

Administration of plasma first for traumatic hemorrhagic shock when brought by ground did not change 28-day mortality.

Prehospital administration of 2 units of thawed plasma in adult trauma patients at risk for hemorrhagic shock reduced mortality compared to standard care, NNT = 10.